Salmonellosis with liver abscess mimicking hepatocellular carcinoma in a diabetic and cirrhotic patient: a case report and review of the literature

Abstract

Salmonellosis with liver abscess in a cirrhotic liver is extremely rare. We report the first case of Salmonellosis with septic shock and liver abscess in a diabetic and cirrhotic patient. The image studies of liver initially favored hepatocellular carcinoma. But no definite focus of sepsis was found. After close follow-up of the liver space-occupied lesion, ultrasound examination revealed the features of liver abscesses at space-occupied lesion later. Ultrasound-guided liver aspiration proved abscess. The clinical and radiological responses were good after antibiotics treatment.

Pyogenic Liver Abscess Mimicking Liver Neoplasm on Computed Tomography Scan in a Patient With Elevated CA 19-9

“…Such mimicry led to, in many cases, incorrect diagnosis and treatment including unnecessary surgery [5][6][7][8][9].…”

“…The absence of fever and leukocytosis resulted in hepatic abscess exclusion, and the patient was exposed to unnecessary surgery [6]. In a contrary case, PLA was reported in a cirrhotic patient who presented with sepsis of unclear etiology [9]. Radiological presentation of hepatic abscesses ranges from hypodense rim-enhancing well-circumscribed cystic lesion to a heterogeneously mosaic enhancing mass [7,10].…”

Hepatic abscess mimicking hepatocellular carcinoma in a patient with alcoholic liver disease

“…Hepatic abscess mimicking HCC has been rarely described in the literature 2,7. Brown et al2 reported cases of hepatic abscess mimicking HCC in the normal liver with contrast-enhanced CT, in which patients presented with high fever and leukocytosis.…”

“…In those cases, hepatic abscesses were accompanied by portal vein thrombosis, and this finding favorably led to the diagnosis of abscess rather than HCC. Chou et al7 reported a case of hepatic abscess in the cirrhotic liver, which mimicked HCC at contrast-enhanced CT, presenting with high fever and marked elevated serum level of C-reactive protein. However, in contrast to previous reports, our case was very difficult to differentiate between hepatic abscess and HCC owing to a lack of clinical presentations suggestive of abscess.…”

Liver Abscesses as Pseudotumoral Lesions

“…In salmonellosis, liver abscesses are caused by S. typhi (Rodriguez and Undurraga 1955;Penaloza et al 1974;Chogle et al 1981;Rovito and Bonanno 1982;Petersen 1984;Matar et al 1990;Soni et al 1994;Ciraj et al 2001;Rogers and Wadula 2001;Chaudhry et al 2003;Chou et al 2006;Kabra and Wadhwa 2006), S. paratyphi A (Rajagopal et al 2002;Chaudhry et al 2003;Jeans and McKendrick 2007), S. enteritidis (Hirschowitz 1952;Collazos et al 1991;Elias et al 1996;Vidal et al 2003;Sheikh et al 2011), S. infantis (Simmers et al 1997), Salmonella group D non-typhi (Choi et al 2006), S. choleraesuis (Luong and Fournier 1960), and S. bareilly (Allegra and Niutta 1957).…”